Willie Kealy: 'Putting a price on priceless work of nurses'

January 13, 2019

Nurses are great. We all love nurses. That’s what everybody says. And anyone who has spent any time under their care in a hospital ward says it frequently. If that sounds a little sentimental, it doesn’t mean our appreciation is any less genuine.

But the question we have to ask is: as a country can we afford to translate our admiration for the members of the nursing profession into paying them whatever money they feel they deserve?

Right now 46,000 nurses are threatening a series of one-day strikes in support of a demand for a 12pc pay increase. And they have two arguments to back up their case.

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The first is the fact that the health service is in constant crisis with abnormally lengthy waiting lists for procedures, and a severe shortage of beds which has led to the scandal of patients lying on trolleys in corridors, with all the attendant indignity and discomfort.

The Irish Nurses and Midwives Organisation – by far the biggest representative body with 40,000 members – reckons that these problems could be solved if there were more nurses, because more nurses means more beds and more theatre time. But because the nurses are so badly paid, it is not possible to attract and/or retain sufficient numbers. So the only solution is to increase nurses’ pay. That is their first argument.

Their second line of approach is that old industrial relations line – relativity. Again, according to the INMO, nurses are paid as much as €7,000 per annum less than medical colleagues who have what they say are comparable qualifications, such as radiographers and physiotherapists.

On the strength of these two lines of argument, the INMO plans one-day strikes on January 30, and February 5, 7, 12, 13 and 14. Their 6,000 colleagues in the Psychiatric Nurses Association plan to ban overtime working on January 31 and on February 5, 6 and 7; and full strike action on February 12, 13 and 14. Both unions will supply their hospitals with emergency cover, and home visits by public health nurses will continue but will be severely restricted.

The third nurses’ union, Siptu, which has 4,000 members, does not plan any industrial action and will pass the pickets but say they will not pick up the slack to “frustrate” the actions of their striking colleagues.

Siptu has decided to stick to the existing pay agreement, which will see some restoration over the next few years (including this year) of pay lost in the recession – a total pay increase of up to 8pc – with the issue of nurses’ pay to be dealt with as a standalone issue in the next agreement. (as part of this agreement, members of the two striking unions are entitled to these benefits also, but only if they refrain from taking industrial action).

This is what the Government and the HSE is hoping they will be able to persuade the nurses threatening strike to also accept when they meet for talks on Tuesday.

It would have a price tag of about €20m and would include increased allowances, better access to promotional posts, and some measures to help lower-paid nurses. And there is the proposal from the Public Service Pay Commission (which came out against the nurses’ demands last September) for a review of nurses’ roles, responsibilities, professional development and pay.

This latter element could be a solution and one that the nurses might accept, but unfortunately it seems the Government does not feel able to enter into such a review any time soon, no doubt aware that it would almost certainly bring them speedily back to having to deal with the present demands.

What makes the Government shy away from the nurses’ pay claim is the overall cost, which they reckon could amount to €300m. But there is also that relativity bugbear. When the “blue flu”-threatening gardai were given a special deal worth €50m two years ago, it cost a further €120m to buy off other public servants who demanded to be treated similarly. And already Forsa, the biggest public service trade union, has made it clear that any concession to the nurses will be followed immediately by demands for parity for other workers.

Looking at the work that our nurses do in such trying circumstances as currently exist in the Irish health service, there is no doubt it is priceless.

But unfortunately we do have to put a price on it and at present, according to the Department of Public Expenditure, that price is €31,110 basic salary with allowances and premium pay bringing the figure to more than €37,000.

So what is the Government to do?

So far the issue has not become a political football. Fianna Fail’s Stephen Donnelly conceded that there isn’t €300m available to pay the nurses overnight, but added: “There is a genuine problem with pay and conditions… I think there is an opportunity to evolve and improve the nursing profession.”

And while Labour says it fully supports the nurses’ decision to go on strike, their health spokesman, Alan Kelly, restricted himself to calling on the Government to “sit down with the nurses to address their issues”.

There can be no disputing the continuing sorry state of the health service. But throwing money at the problem as a prospective solution has been discredited, with budget after budget overrun, so that eventually you have to look at the system and the way the service is managed by those in charge.

Nobody can deny the vital role of nurses in the health service, the contribution they make or the potential they have to help improve the situation. But it is doubtful if making it worse with one-day strikes to make it better is the best approach.

And while they undoubtedly have the best interests of their patients in mind when they say that more nurses and an end to the exodus of young nursing talent from our hospitals is imperative, linking their pay demands to the pay of others helps us see the pure industrial relations aspect of this dispute.

So perhaps we should put aside all sentiment, so that the parties concerned can see it as a simple industrial relations dispute for higher pay, with the normal mechanisms of the Labour Relations Commission and the Labour Court available, when the two sides sit down to talks this week.